医学
腺样囊性癌
回顾性队列研究
比例危险模型
放射治疗
放化疗
内科学
癌
肿瘤科
多元分析
阶段(地层学)
胃肠病学
外科
泌尿科
古生物学
生物
作者
Cheng‐En Hsieh,Yi–Hong Chou,Chen-Yu Hung,Li‐Yu Lee,Bhanu Prasad Venkatesulu,Shyh‐Chin Huang,Chun‐Ta Liao,Nai‐Ming Cheng,Hung‐Ming Wang,Chieh‐Shan Wu,Chung‐Jan Kang,Miao‐Fen Chen,Ya-Min Cheng,Kun‐Yun Yeh,Cheng‐Hsu Wang,Wen‐Chi Chou,Ching-Yi Lin
标识
DOI:10.1016/j.radonc.2023.109891
摘要
The aim of this study was to interrogate if the use of postoperative chemoradiotherapy (POCRT) correlated with superior oncological outcomes for certain subgroups of patients with high-risk salivary gland carcinoma (SGC), compared with postoperative radiotherapy (PORT) alone.This multicenter retrospective study included 411 patients with surgically resected SGC who underwent PORT (n = 263) or POCRT (n = 148) between 2000 and 2015. Possible correlations of clinical parameters with outcomes were examined using the Kaplan-Meier analysis and Cox proportional-hazards regression model.The median follow-up of survivors is 10.9 years. For the entire cohort, adding concurrent chemotherapy to PORT was not associated with OS, PFS, or LRC improvement. However, patients with nodal metastasis who underwent POCRT had significantly higher 10-year OS (46.2% vs. 18.2%, P = 0.009) and PFS (38.7% vs. 10.0%, P = 0.009) rates than those treated with PORT alone. The presence of postoperative macroscopic residual tumor (R2 resection) was identified as an independent prognosticator for inferior OS (P = 0.032), PFS (P = 0.001), and LRC (P = 0.007). Importantly, POCRT significantly correlated with higher 10-year LRC rates in patients with R2 resection (74.2% vs. 40.7%, P = 0.034) or adenoid cystic carcinoma (AdCC, 97.6% vs. 83.6%, P = 0.039). On multivariate analyses, the use of POCRT significantly predicted superior OS (P = 0.037) and PFS (P = 0.013) for node-positive patients and LRC for patients with R2 resection (P = 0.041) or AdCC (P = 0.005).For surgically resected SGC, POCRT was associated with improved long-term OS and PFS for patients with nodal metastasis and superior LRC for patients with R2 resection or AdCC.
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